Cultural Awareness - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

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Cultural Awareness

• Accepts individual differences.
• Actively listens to other employees' stories about their culture.
• Willing to work with employees who have different cultural backgrounds.
• Avoids referring to stereotypes about others from different cultures.
• Respects the views offered by individuals with different cultural backgrounds.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Problem Solving

• Evaluates alternative courses of action.
• Identifies and assembles the necessary resources (e.g., budget, tools, equipment, personnel) required to implement the action plan.
• Effective in developing innovative products and services.
• Recognizes the challenges that have emerged or are about to emerge.
• Determines the order in which the action steps need to be completed including steps that may be dependent on others.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Technical

• Willingly shares information and expertise; sought out as resource by others
• Knows how to produce high quality products/work.
• Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
• Demonstrates mastery of the technical competencies required in his/her work.
• Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Objectives

• Organizes and schedules events, activities, and resources.
• Ability to establish realistic goals.
• Establishes goals and objectives.
• Effectively organizes resources and plans
• Able to organize work.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Trustworthy

• Demonstrates a sense of responsibility and commitment to public trust.
• Delivers on promises made.
• Consistently keeps commitments.
• Takes ownership, delivers on commitments
• Takes care to maintain confidential information.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.